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�B�A��� PuCLcWorY�ParmM� �/ <br /> Applicetion For Bieo 0•oi • <br /> PUBLIC WORKS PERMIT °�°;a„�;`� � <br /> La..�oo� FM Pue � <br /> TI? nn r i.-� O 1 7d00 00 <br /> Print or T��PB OflIY J�TI�II _.._,___ &iuncaUue f�p--- <br /> LG":_a_�c,.` Cow�<_.f �i.,c, 1�1zil4 �'�ssfF�� U.�d.0`-;z_�'11,E�� `'1401 �E31 - 8'�(p(lJ <br /> Owner Mailing Address CitY 7iP Phone <br /> l.t+.'Ea.L..—�oUEi71_d...11> F�d� ¢» , � <br /> �- �_ ,,.r Z� L�NI�Jro�� 9��3�0 -7�r-_isyj <br /> Applicent Mailing Address Cily Iip Phone <br /> Dencribe P�oposed Wmk ��L"J";?FLYTi..,, j p� �j,p �q� GY !��,-� '�1 QA�n _ / <br /> �l <br /> /x.11� f�.�n.� ��i4`o2dT� ?.� [9_ /�� CY" �aU .i�� .�-..�� � I�� JT � � <br /> P�o�ect AdAress 111 known� Z�( — ��,�-�. rl,�j2�"y� ` WA, — � <br /> Altach(our(4)copies ol plans lor proposed wor�� Draw to scele...•d nole the lollowir g as epplicable: � <br /> • P�oparty Lmes • Cente�G �e o�streel � <br /> • Outline end dimensions ol all e�istmg xnd • Indlcete North <br /> proposed slructures on Ihe lol • Snow any pro��osed greding changes <br /> • Exislfng and proposed utililips • Show measur¢menfs � <br /> )NOT WqITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspactlon ahell be mede 24 hrs.in aovance-phone 259•8810. � <br /> 2.All work ahall be pe.formed In a,:r.ordance with this permit and current Clly ol Everett Dasipn and Conetruct�on <br /> Stendarde end Specllicetlona. <br /> 3.Call Locetlon Underground Service 48 hrs,before you dlg.TOLL FREE NUMBER 1•800•424•5555. � <br /> A. CCni7771��T� �e.r: . �� �• i-?Ac �,_ i i�� �c ��,� e�ll. <br /> �. TR-AFF�� � cN�rcoi.. �x•r c' ��Y � N :;Q«.�r��. O <br /> c,,, Klzl� �� �1y' ;lt�< Z-T r.��n�, 03/19/90 12:46FM O�RN(1510 �IIiM <br /> / � <br /> k00030P47 <br /> oPt.zo s2o.o� � <br /> casH k�.ao <br /> Q <br /> ACKNOWLEDGE-MENi OF CONDITIONS <br /> _ ___ ihe undersipnod owner/app6cent hereby ayreos lo hold antl eeve heim� <br /> ,� less the CiPi ol Everelt Irom eny end ail claims lor demages. cosls. <br /> _f"� i��. /j e■pensas. r causes of eclion that may erise because of Inelellation <br /> � ,�j, �- end mel nnnce of Ihe improvement o� other ripht�obwey use herelo <br /> �� applie or and lurt er e rees to remove eame upon notice Irom tbt <br /> PPnv Oc 'unetryc�ion - ' Dale <br /> - �� Gt lo re nc 6f property damagetl the�aby. <br /> , �_ <br /> '/ .� y i <br /> NHL INSPECTIOPY� !� ���� . • (�� 3 / D <br /> Approved as Con�iructed gnxtur� 01 Applican <br /> Date <br /> e��emft PUBLI�WORKS DEPARTMENT UMr: AUTHORIZED THIS t'EfiMIT MUS'� BE STAHTE� WITHIN <br /> � 3200CadarSlraet 180 OAvS OF �ATE PERMIT IS ISSUEO AND THENEAFTFq IS TO <br /> Everalt.WA gB201 BE DILIGENT�V PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:?59�8810 CANCEL LED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> PHUJECT OVER AU DAVS DURATION. <br />